Ignoring, Denying, and Downplaying Epidemics: A Brief History
“Everybody knows that pestilences have a way of recurring in the world,” Albert Camus writes in his classic novel The Plague, “yet somehow we find it hard to believe in ones that crash down on our heads from a blue sky. There have been as many plagues as wars in history; yet always plagues and wars take people equally by surprise.”
Many people have equated the propensity for certain institutions and individuals to deny the imminent danger posed by COVID-19 to 2003’s SARS epidemic, which was downplayed by certain nations and not even acknowledged by others. However, Camus’s astute observation about the human tendency to ignore the invisible rampage of infectious disease came in 1947, long before SARS took the global stage. From the Spanish Flu to HIV, we have denied, minimized, and ignored the threat of infectious illness. How and why have we ignored history’s epidemics and what have we failed to learn from our past as COVID-19 continues to reap global havoc?
Photo: Rat trappers in 1914, New Orleans, during an outbreak of Bubonic Plague.
In 1900, a man was found dead in San Francisco’s Chinatown neighborhood, covered in bubos. 41-year-old Chick Gin had succumb to the first known case of bubonic plague in North America.
Although the case was soon laboratory-confirmed, California governor Henry Gage was hesitant to acknowledge the outbreak. Local newspapers like the San Francisco Chronicle ran headlines questioning the veracity of the plague case, stating that the “Plague Fake is Part of a Plot to Ravage the Economy.” Other sources did acknowledge the presence of the plague outbreak, but minimized its effect: “[the plague is] less dangerous than measles, mumps.”
Despite medical authorities’ ongoing research and treatment of plague cases, Gage denied the existence of the epidemic for more than two years, fearing that quarantine or public shut-down would result in severe and unwarranted economic loss. He went so far as to threaten to pull funding from University of California, Berkeley if their resident biologists and physicians continued to study the outbreak.
By 1904, 121 plague patients had been identified, 119 of whom died.
The Spanish Flu of 1918 took 50 million lives worldwide. Yet as influenza prevalence rose, so too did censorship about its spread.
During World War I, global media attention was focused on military efforts. Information about the flu was minimized to keep up national morale. Spain, a neutral party in the war, was free to disseminate information on the pandemic, inscribing the names of those who had died from the illness on the front pages of their newspapers and earning the illness its false moniker of “Spanish” flu.
Germany, the United States, the United Kingdom, Italy, and France similarly minimized reports of the true incidence and mortality rates, the length of outbreaks, and the etiology of the disease. The result was a global failure to prepare for and to prevent outbreaks.
“HIV does not cause AIDS.”
1980 marked the beginning of an HIV/AIDS pandemic that continues to this day. It also marks the beginning of an era of HIV denial in research and politics. In a 1987 article, Peter Duesberg insisted that HIV is a “harmless passenger virus” and does not lead to AIDS, echoing the sentiments those who believe antiretroviral therapies are toxic and unnecessary.
Between 1981 and 2000, 450,000 people died of HIV/AIDS in the US alone, a toll that some activists credit to the “malign neglect” of a government that ignored the early warning signs of an epidemic. The retrovirus continued to spread globally. According to UNAIDS data, by 2018, nearly 40 million people were living with HIV, 68% of whom live in sub-Saharan Africa.
Despite the spread of the virus and decades of campaigns for both scientific and social acceptance of the illness, AIDS “denialism” persists in many parts of the world, slowing access to testing and treatment, a phenomenon that has been referred to by former British cabinet member Peter Mandelson as “genocide by sloth.”
In 2002, cases of Sever Acute Respiratory Syndrome (SARS) were detected in Guangdong and Hong Kong. However, reports of these cases did not reach top health officials until January 2003.
According to laws dictating the handling of public health information, infectious disease outbreaks are to be classified as state secrets. Any journalist, researcher, or physician who divulged information about SARS before an official go-ahead could be persecuted for revealing these secrets. In January 2003, the Hueyuan Daily wrote an article called “There is No Epidemic in Hueyuan.”
Despite attempts to keep SARS under wraps, by February, much of the Chinese public had learned of the virus through unofficial sources. On March 15th, WHO issued its first press release declaring SARS a public health emergency.
By 2004, over 8000 people were infected in 29 countries worldwide. 774 died.
In March 2014, Guinea confirmed suspicions of a case of Ebola, four months after patient zero’s death. By that time, the virus, which has an average case fatality rate of 50%, had spread to Sierra Leone, Liberia, Nigeria, and Senegal.
Not wishing to deter travel to Guinea that would incur economic damage, the Guinean government and greatly downplayed the extent of the outbreak. Only after pressure from Médecins San Frontières did Guinea and WHO declare the outbreak an epidemic and a public health emergency in August 2014.
The outbreak ended in 2016 after 28,600 cases and 11,325 deaths.
COVID-19 & Beyond
Denial and inaction categorized the initial responses to the contemporary COVID-19 pandemic.
Reflective of the SARS epidemic nearly 20 years ago, when Dr. Li Wenliang, working in Wuhan Central Hospital, warned fellow physicians about a potential new outbreak, he was accused by police of rumormongering.
Although some have extolled China’s response to the outbreak as swift and effective, sealing off Wuhan taking strict measures to enforce physical distancing, others have still accused the Chinese government of undercounting cases and not giving international medical experts access to China’s data soon enough.
Nearby nations that took strong proactive measures like Singapore and South Korea found great success in suppressing large outbreaks. Elsewhere, social distancing measured were enacted too late. In Russia and Indonesia, for example, early media reports stated that the virus was “under control” even as thousands were being infected. A deep politicization of the virus in the United States and failure to meet testing demands has resulted in combined growth of case numbers and the number of protests to re-open the economy in spite of a (perceived) minimal viral threat.
Pandemics expose the cracks in every national and international system: healthcare, housing, economy, etc. Viruses do not respect manmade borders. In an effort to regain a sense of control over nature, to calm, to ensure, to bolster the morale of their people, and perhaps in part out of a culture of national exceptionalism, responses to these viral entities are often deny, delay, and disrupted. The result: a selective distrust of science, political scapegoating, and a rising death toll.
‘The general public, like Camus’ townsfolk, are “wrapped up in themselves…humanists: they disbelieved in pestilences.” Perhaps next time we, and our leaders, will remember that a pestilence is not “a mere body of the mind, a bad dream that will pass away…it is men who pass away.”
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